Contraception Series Part 2: Paragard, the Non-Hormonal IUD

by novanilla

For those of you who read the first installment of my contraceptive series, this is the second installment, in which I will provide accessible written information about Paragard. Paragard is my favorite contraceptive to talk about because, well, I use it! This article will provide information about the basics of Paragard— everything you need to know when making your decision about what contraceptive is best for you.

What is Paragard?

So first, what exactly is Paragard? Paragard is a little T-shaped piece of plastic wrapped in copper, but not enough to be toxic to your system, so don't worry. This is no more dangerous than any other contraceptive device. In fact, I consider Paragard to be the least dangerous and invasive of all contraceptives that are placed in the body for more than one sex session. This is because it does not affect the menstrual cycle at all.

I talk to people a lot about intrauterine devices, or IUDs, and very frequently people say that a non-hormonal IUD would not work nearly as well as hormonal contraception, or that Mirena is the only option, or even that Paragard is more dangerous than other forms of birth control, and most frequently, they have no idea how long each IUD lasts. Although I’ll focus more on it next time, Mirena lasts up to five years. Paragard lasts up to ten years. With each of these options, if you decide that you don’t like it or that you want to become pregnant, you can remove it before its time is up.

A lot of people don’t hear about Paragard much because of the myths surrounding IUDs. Non-hormonal contraception receives very little attention and is used rarely - with the exception of condoms and spermicide. The idea that an IUD like Paragard is dangerous comes from true horror stories, but they should not concern a woman in the 20th century. IUDs such as the Dalkon Shield, a police-badge-shaped IUD, was legitimately dangerous. It hurt, and even killed, many women via bleeding and infection. It was a horrible design, along with many of the other hundreds of IUDs that have been used in previous centuries. Paragard, however, has been used safely in America for about twenty years.

No Hormones? How does it work?

Because Paragard is partially made of flexible plastic, it does not require dilation of the cervix in the same way that old, completely metal IUDs did. However, it releases a small amount of copper, a metal that has been used for contraception since women drank a mixture of water and copper ore for contraception in ancient Greece. Although no one is completely sure how copper prevents pregnancy, there are a number of theories. One is that the uterus becomes inhospitable for pregnancy due to the copper, which would make sense given its toxicity. It may not affect the woman, but a small embryo could be more heavily affected. Another theory is that the copper encourages the uterus to produce a compound that kills sperm. Regardless, it’s incredibly effective. For every 1000 women who use it per year, 10 will become pregnant, so it has a failure rate of 1% when it is the only contraception used. When used in conjunction with condoms, spermicide, or another method, this rate decreases.

Of course every woman is different, but my sister and I had similar insertion experiences with Paragard; it took us each about ten minutes, and we felt a strong pinching. Then, it was over. Many people are scared of insertion, but if you have a good gynecologist who has inserted IUDs before and has been trained to do so, you should not be scared. If you have a very low pain tolerance, perhaps just take some ibuprofen beforehand. I didn’t need to have my cervix dilated, and I’m a very young woman who has never been pregnant. Anyone can get an IUD inserted, really!

What happens once I get it?

On to the side effects: because Paragard is non-hormonal, there are very few side effects to this contraceptive option. Infections are more likely to occur due to the string that is attached to the device - for the purpose of removal and checking to ensure it has not expelled itself. Expelling is another side effect. Expulsion is incredibly rare, but it occasionally happens. This just means that the uterus pushes out the IUD—it falls out, essentially, or at least out of place. There is not anything a woman can do to prevent this from happening aside from not pulling on the string. Sometimes, Paragard can also cause heavier bleeding and cramps.

So who should use Paragard, and who should not? Women who want low-maintenance birth control that’s always there when you need it but requires absolutely no effort, those looking into sterilization but aren’t sure yet, those who use contraception solely not to get pregnant, those who don't want children for a number of years (such as students or people starting a career), and those who want to avoid hormones without relying on barrier methods or spermicide, among others! Who should not use it? Those who use contraception for reasons other than pregnancy prevention and those with heavy and/or painful periods, particularly those with conditions like endometriosis.

If this method fails and you choose to carry the pregnancy to term, see a doctor immediately to remove the device. Pregnancies that occur while using Paragard can cause serious problems like ectopic pregnancy, a pregnancy that occurs outside of the uterus such as in the ovaries or fallopian tubes. These are very dangerous and need to be resolved immediately. If you are using Paragard and think you may be pregnant, find out as soon as possible.

Next time, I’ll be covering the other modern intrauterine device, the hormonal option, Mirena. If you have questions about Paragard that I did not address here, either send me a message or ask in comments!